Pharmacy Testing Manager – PBM, Medicaid

🕒 October 1

🌲 North Carolina – Remote

🌲 North Carolina – Remote

💵 $86.7k - $123.9k / year

⏰ Full Time

🟠 Senior

🔴 Lead

💊 Pharmacist

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 4%

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Gainwell Technologies

WebsiteLinkedInAll Job Openings

10,000+ employees

💼 Consulting

📦 Logistics

⚕️ Healthcare Insurance

💰 Grant on 2023-06

Consulting • Logistics • Healthcare Insurance

Gainwell Technologies is the nation’s leading provider of digital and cloud-enabled solutions across the human services and public health ecosystem. With a mission-driven approach, Gainwell serves clients in all 50 U. S. states, focusing on improving health outcomes and delivering intuitive, human-centered experiences. Their comprehensive suite of solutions includes Medicaid Enterprise modernization, data analytics, provider services, and pharmacy solutions, all designed to advance the future of healthcare and enhance community well-being.

📋 Description

• Lead end-to-end pharmacy testing across SIT, UAT, Regression, Parallel Testing, and Production Validation • Develop and manage test strategy, plans, schedules, and execution governance • Ensure alignment with business requirements, CMS guidelines, and state Medicaid regulations • Oversee pharmacy functional validation, including claims adjudication, drug pricing, formulary management, prior authorization, rebates, NCPDP transactions, and financial reconciliation processes • Manage defects and coordinate among business SMEs, vendors, developers, conversion teams, and testing resources • Provide leadership reporting and stakeholder communication by tracking quality metrics, risks, issues, and test progress

🎯 Requirements

• 10+ years of software testing experience • 5+ years of Test Management experience • Strong PBM or Medicaid pharmacy experience • Experience with large-scale DDI or MMIS modernization programs • Expertise in claims adjudication • Expertise in NCPDP transactions • Expertise in prior authorization • Expertise in formulary management • Expertise in drug rebate processing • Expertise in pharmacy financial validation • Experience using ALM/JIRA • Experience using SQL for data validation

🏖️ Benefits

• Work flexibility • Learning and career development opportunities • Technical credentials and certifications • Generous, flexible vacation policy • Educational assistance • Leadership and technical development academies • 401(k) employer match • Comprehensive health benefits • Occasional travel opportunities

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